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NPI Code Detail

MEDICARE: MISS JUANA YAVONNE WILLIAMS

MEDICARE: MISS JUANA YAVONNE WILLIAMS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1982735973
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JUANA YAVONNE WILLIAMS
Provider Business Mailing Address
First Line : 5190 ATLANTIC AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90805-6510
Country : US
Telephone Number : 562-428-4111
Fax Number :
Provider Business Practice Location Address
First Line : 5190 ATLANTIC AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90805-6510
Country : US
Telephone Number : 562-428-4111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2007
Last Update Date : 09/11/2025

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